(Mental Health) When Depression Strikes a Friend

06Jun

Last Monday, I posted a quick primer on what happens physically and chemically to the brain when depression strikes. On Wednesday, I talked a little bit about what that feels like for me. I wanted to state (again) that depression and other mental illnesses are incredibly varied and complex; there’s not a single cause or expression of it, and everyone’s experience and struggle with it will be different. However, I’m hoping that talking about it will give people a better idea of what it’s like to live with it.

Today I want to talk about how we can help loved ones who are depressed, especially when they’re in the middle of an episode. It’s fairly common for people living with depression to have periods where they’re managing OK and things are at some kind of baseline, then fall into an abyss when chemicals or external factors shift. Even when they’re doing everything possible to manage themselves, this can happen. It’s no one’s fault when it does — that’s just the nature of this illness.

It can be exceedingly difficult to watch someone you’re close to go through that. You can see them start to think horrible things about themselves and the world around them; to sink down into a hopelessness that causes a complete negation of who they are; to watch them say or do things to make the situation actively worse. Because we’re a social species, and because we genuinely care about these people, their despair can frequently become our own. And because most of us don’t know exactly what’s wrong, any attempts to fix it at best do nothing and at worst only pushes the person further down that pit. Helplessness becomes frustration, and frustration can become anger.

As someone with depression who’ve also dealt with a number of loved ones going through the same thing, I get it. I’ve been on both sides of this equation. I know what it’s like to be in the mental space that says I’m a terrible person living in a terrible world and nothing will ever get better. And I know what it’s like to speak with someone like that, to try to make them feel better, to feel the panic and maddening frustration when everything in my bag of tricks simply doesn’t work.

So this is as much for myself as it is for anyone else in these situations. It can be hard to remember a few things that may help us relate to someone in the grips of depression a little better. If you have your own recommendations, or would like to share your experiences, or would like to offer feedback on mine, please feel free.

First, please remember that your friend is in the grips of an illness. This is an actual disease that affects the way your loved one thinks; those thoughts can lead to words and actions that are difficult to deal with. Most of the time, all we’re going to see is what our loved ones say or do. As with most invisible diseases, that’s just the tip of the iceberg. There are a host of interrelated thoughts, experiences and body processes that lead to that result that we’re not aware of. It’s important to keep that in mind — your loved one is having trouble coping with what is happening with them, and that often leads to behavior that doesn’t make sense or can be outwardly intensely aggravating.

In times like these, I’ve found it helpful to try my best to keep in mind that this person is effectively disabled and treat them as such. We wouldn’t expect someone in a wheelchair to just grab something off the top shelf, and we wouldn’t expect someone who’s diabetic to just eat something that would send their glucose through the roof. During episodes where our coping mechanisms fail or we enter the depths of our illness, please don’t expect us to just behave normally or think differently or be something else. It’s exceedingly difficult, if not impossible.

When we talk about everything that’s gone wrong in our lives, it’s often not that we have no idea how to solve these problems (though that may certainly be the case). It’s that depression or anxiety looking for a reason to exist, latching onto anything it can find to take root and become more permanent. I don’t want to say that a depressed person complaining about their lot in life has nothing to complain about; what I am saying is that what’s going wrong feels insurmountable and unsolvable when we’re at our worst, whether it’s true or not. For us, that perception is reality. Life is fundamentally broken, and it can’t be fixed.

I think this is what lies at the fundamental disconnect between a depressed person and a loved one. There is that seemingly unbridgeable gulf between our perception and theirs. To someone in a depression, no one understands just how awful things are, how wretched and permanent. To someone watching depression from the outside, this loved one doesn’t understand just how much they are loved and have people willing to help them if they would just get up and try.

I believe the best thing we can do for our depressed brothers and sisters is to accept them as they are, in that moment. When I’m in that valley and I talk about how terrible things are, I’m not necessarily looking for a fix; I’m looking for understanding, for the comfort that comes with connection, for someone to take my hand and say “I hear you, and I know that you are suffering.”

That can require an extraordinary amount of empathy. So many of us don’t like sitting with difficult emotions, even if we’re the ones feeling them. We look for ways to stop being angry or sad or uncomfortable as quickly as possible, and because we’ve never developed the patience or compassion for ourselves to allow these emotions to exist within us when it appears in others we simply cannot tolerate it. We want THEM to stop it as quickly as possible, too.

So when a depressed loved one comes to us with their difficulty, we treat the situation like we would treat it in ourselves. How can we fix this? How can we distract from this? How do we stop this? The short answer is that we can’t. We must simply accept it, be in that difficult space, find a way to bear it, however we can.

That load is lessened so much when there is someone willing to be with us in those moments. Just hearing someone say “I know this is awful. I am here for you.” can make an unbearable, permanent situation feel like something that is “only” difficult. Hearing someone try to offer solutions to my problems can have a paradoxical alienating effect; I know that they’re only trying to help, but the attempts to offer solutions only underscores the fact that they don’t understand me. Sometimes, it forces me to admit that I don’t understand myself at those times.

Like a cold, or a bad flare-up of arthritis, or some other chronic disease, depression is not necessarily something that can be fixed. When it happens, we can only manage it as well as we can. Because it affects the way we think, speak and act, those of us in the thick of it are often unable to do what we need in order to manage it. As part of the support network, sometimes it falls to us to find ways to make that happen.

Empathy, patience and understanding are necessary for this. I understand that so many of us have that in limited supply, mainly because we’re dealing with our own issues. Taking on the suffering of someone else is not easy, even in the best of times. But whatever we can offer to someone else has a tremendous effect.

Finally, please be sure to take care of yourself. I know how difficult I was on the people around me during my worst depressions, and I know that a lot of these people burned themselves out giving and giving and giving without making sure they were OK as well. Do what you need in order to be OK; get good sleep, eat well, talk to someone about your experiences and difficulties, if you can. It’s impossible to care for someone else if you don’t care for yourself first.

Wednesday, I’ll offer advice on what we can do, as depressed people, to care for ourselves. All of this is first drafty, but I hope it’s helpful anyway. It’s important that we at least begin these types of conversations.